Dr Mayoni Gooneratne on Functional Medicine, Perimenopause, and Building Healthspan Through Prevention

What if the conditions we treat in our fifties and sixties which were set in motion decades earlier, would have been spotted, and shifted, far sooner?

In this episode of Beyond Longevity, I sit down with Dr Mayoni Gooneratne, Founder and Medical Director of Human Health and Skin Fit Clinics, and Vice President of the British College of Functional Medicine. After years as an NHS colorectal and pelvic floor surgeon treating advanced disease, she made a decisive pivot into functional and preventative medicine with a sharp focus on women’s midlife health.

Dr Mayoni is frank about what she sees as the fault lines in modern healthcare: too little time to truly listen, a default toward symptom management over root-cause thinking, and a system designed to meet patients at crisis point rather than upstream. Her own definition of “good medicine” is different: deeper connection, individualised biology, and practical tools that help patients protect their own healthspan.

A major thread is perimenopause — why it is still under-recognised in conventional medicine and, surprisingly, even in the longevity conversation. She links this to the long-standing marginalisation of women in medical research, and the real-world consequences that follow. Her solution starts with “body literacy”: tracking patterns, paying attention to symptoms, using health data intelligently, and becoming an active participant in care and not simply waiting for a label.

We get into the specifics of her clinical approach: detailed history-taking and questionnaires, then targeted testing to confirm or disprove a hypothesis. She explains how she uses broad blood marker panels, aiming for optimal, not just “normal” ranges, stool testing to assess gut function, and nutrigenomics to understand how someone interacts with their environment. For anyone sceptical about functional medicine’s reputation for over-testing, her line is clear: testing should have a reason and early markers (like homocysteine and methylation issues) are worth catching before they become disease.

Her framework comes through in a powerful case study of a woman in her mid-forties post breast cancer treatment. The plan combined structured nutrition changes, Pilates to support bone health, and journaling to work through stored stress and anger, with measurable improvements in sleep and HRV.

Practical advice runs throughout: build a simple morning routine, prioritise nourishing food, choose “joyful movement” over punishment, reduce blue light and phone use at night, and rebuild real-world community. She also shares what she believes conventional medicine needs more of: stronger grounding in biochemistry and physiology, better nutrition education, and a far more serious commitment to women’s health.

Beyond the clinic, Dr Mayoni is also building infrastructure for the field. Through Human Health Professionals, she trains and mentors clinic owners to deliver longevity and wellness services responsibly. She also leads the Future Patient Congress and publishes Future Patient, quarterly, evidence-based resources magazine, designed to make current research more accessible and usable for clinicians and practitioners.

In the rapid-fire round: her single most important longevity adjustment, what she wishes she had known before leaving surgery, and what it really means to extend healthspan - not just lifespan.

BCFM College of Functional Medicine

Human Health™ by The Clinic | Functional Medicine in London

The Clinic by Dr Mayoni - Integrative Skin Care Clinic in London

Redefine Healthgevity and Metabolic Wellness | Human Health Professionals

Future-proofing patients’ health - Future Patient

00:00 Welcome to Beyond Longevity + Meet Dr. Mayoni Gooneratne

00:45 From NHS Surgery to Prevention: Why Patients Reach Crisis Point

06:01 What “Good Medicine” Looks Like: Time, Listening, and Healing Space

10:47 Why Perimenopause Is Still Overlooked (and Why It Matters for Longevity)

12:36 Body Literacy & Wearables: Turning Symptoms into Useful Data

14:47 Gaslighting, Doctor Google, and Empowering Women to Self-Advocate

17:39 Longevity Isn’t Just for Biohackers: Women’s Health as a Public Health Priority

20:42 Testing in Functional Medicine: History First, Then Blood, Gut & Nutrigenomics

24:16 “Too Much Testing?” Early Warning Markers, Methylation, and Going Upstream

26:43 Clinical Framework: How to Prioritise Systems When Everything Feels Off

29:22 The ‘House’ Analogy: Gut Foundations, Immune Roof, Stress Storms & Routines

32:45 Case Study: Post–Breast Cancer Optimisation—Metabolic Health, Protein, and Nervous System Reset

36:16 Healing Stored Anger: A Patient’s Nervous System Breakthrough

38:49 Perimenopause 101: Recognising the Early Signs & Symptoms

39:53 Food, Movement, Sleep: The Core Lifestyle Reset (Without Punishment)

42:10 Relationships, Boundaries & Reducing Toxic Inputs

45:18 Five Simple Longevity Adjustments: Morning Routine, Nutrition, Phone, Community

48:47 What Conventional Medicine Could Change Now (Nutrition + Women’s Health Education)

51:23 Why She Left Surgery: The Wake-Up Call on Reactive Healthcare

56:09 Building New Systems: Human Health, Future Patient Congress & Magazine

57:47 Training Clinicians: N=1 Medicine, Critical Appraisal & Practical Protocols

01:06:22 Rapid-Fire Longevity Q&A + Final Takeaways on Healthspan